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• First Name:
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Demographic Questionnaire
To ensure that InsuranceNewsNet Magazine delivers content that matters to you, please take a moment to answer this brief demographic questionnaire. These questions are not required, but help us learn more about our audience.
Which of the following professional roles
reflect your business activities?
Financial Planner / Consultant
Certified Public Accountant (CPA)
Life/Health Insurance Agent/Broker
Property/Casualty Insurance Agent/Broker
Life General Agent or Manager
Insurance Company Personnel
Other (please specify)
Last year, what was the amount of your paid personal life or annuity production:
-- Please select one --
$10 Million or more
$5 - $9.9 Million
$4 - $4.9 Million
$1 - $1.9 Million
$500,000 - $999,999
$250,000 - $499,999
$100,000 - $424,999
$50,000 - $99,999
Under $50,000
I am involved in selling the following (select all that apply):
My annual income is:
-- Please select one --
Under $55000
$55000 - $99000
$100000 - $199000
$200000 - $300000
Over $300000
Number of agents in my organization:
-- Please select one --
Under 10
10 - 49
50 - 100
Over 100
I have been involved in selling INSURANCE for:
-- Please select one --
Under 3 Years
3 - 10 Years
11 - 20 Years
Over 20 Years
I do not sell insurance
I have been involved in selling SECURITIES for:
-- Please select one --
Under 3 Years
3 - 10 Years
11 - 20 Years
Over 20 Years
I do not sell securities
I am currently (select one):
Independent
Semi-Captive
Captive
I am a member of (select all that apply):
Licenses and Designations (currently holding
or working towards, select all that apply):
I would like to receive email offers and
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• What is the day of the month you were born?
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